Provider Demographics
NPI:1659749810
Name:SPECIALTY DENTAL PARTNERS OF AUSTIN PLLC
Entity Type:Organization
Organization Name:SPECIALTY DENTAL PARTNERS OF AUSTIN PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHIAPARELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-800-8040
Mailing Address - Street 1:136 4TH ST N STE 201
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-3889
Mailing Address - Country:US
Mailing Address - Phone:727-800-8026
Mailing Address - Fax:727-304-3164
Practice Address - Street 1:4308 N QUINLAN PARK RD STE 201
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-6071
Practice Address - Country:US
Practice Address - Phone:512-212-7503
Practice Address - Fax:512-266-6197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-04
Last Update Date:2023-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX216351223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty